Abstract
We reviewed patients with musculoskeletal tumors treated at our institution between April 1999 and March 2011 in the light of the current shortage of specialists in this field. The subjects were 866 patients. The proportion of those with musculoskeletal tumors increased over the study period, whereas that of patients with other malignant tumors showed no remarkable change. Every year, 80-90% of the treated patients had been referred from nearby clinics, and some of these patients were returned to the original clinics after treatment at our institution. The proportion of such returnees was 29.3% in 1999, and had risen to 62.8% in 2010. In the studied district, general orthopedic surgeons do not attempt to treat musculoskeletal tumors even if they are not malignant because of the risk of misdiagnosis. However, if all patients with musculoskeletal tumors become concentrated at a specialized institution, the number of orthopedic surgeons qualified to deal with them will eventually become insufficient. One way of preventing this problem is to return such patients to their referring clinics after treatment, and assigning follow-up to them. If specialists still remain fully occupied, it will become necessary for specific institutions to specialize in the treatment of malignant tumors, and for benign tumors to be treated at other hospitals.
